重复经颅磁刺激治疗脑瘫患儿的疗效观察

Therapeutic effectiveness of repetitive transcranial magnetic stimulation for children with cerebral palsy

目的:观察重复经颅磁刺激(rTMS)联合康复训练治疗脑瘫患儿的疗效,探讨此治疗方法对脑瘫儿童综合功能的促进作用。方法:将42例脑瘫患儿随机分为2组各21例,2组脑瘫儿童均接受康复治疗,包括PT训练、OT训练、语言训练、特殊教育等项目;观察组在康复训练的基础上增加rTMS。2组患儿在康复治疗前后进行粗大运动功能分级系统(GMFM)和Gesell发育诊断量表检查评定。结果:治疗8周后,2组患儿GMFM评分5个维度均较治疗前有提高,其中维度A、维度B、维度C、维度D组内比较均有显著性差异(P<0.05);治疗后组间比较,维度A及维度C 2组间比较有显著性差异(P<0.05)。治疗8周后,2组患儿组内比较显示Gesell评分5个能区均有提高,其中大运动能区、精细动作能区、语言能区组内比较有显著性差异(P<0.05);治疗后组间比较,观察组大运动能区及语言能区较对照组提高得更明显(P<0.05)。结论:rTMS联合康复训练治疗脑瘫的效果肯定,可以促进患儿运动功能和语言功能发育。

Objective:To observe the effect of repetitive transcranial magnetic stimulation(rTMS)combined with rehabilitation exercise for children with cerebral palsy,and to investigate the improvement of the comprehensive function in these children.Methods:Forty-two children with cerebral palsy were divided into two groups.Both groups were treated by routine rehabilitation therapy,including physical therapy,occupational therapy,speech therapy,special education,etc.The observation group was treated not only by routine therapy,but also by rTMS.The children were assessed by GMFM and GESELL before and after treatment.Results:In both groups,the 5 items of the GMFM increased after 8 weeks of treatment,and the item A,B,C,D scales of the GMFM increased significantly(P<0.05).In the intergroup comparison after treatment,the item A,C scales in observation group were improved significantly as compared with control group(P<0.05).In both groups,the 5 functional areas of GESELL increased after 8 weeks of treatment,and the Month Age of the Gross Motor,Fine Motor and Language in GESELL increased significantly(P<0.05).In the intergroup comparison after treatment,the Month Age of the Gross Motor and Language in the observation group were improved significantly as compared with control group(P<0.05).Conclusion:The effect of rTMS combined with rehabilitation exercise for children with cerebral palsy is positive,and can promote the development of motor function and language function.